[Atticotomy with canaloplasty and tympanoplasty for limited epitympanic cholesteatoma].

OBJECTIVE: To observe the surgical results of atticotomy with canalopalsty and tympanoplasty for limited cholesteatoma. METHOD: Thirty-one cases of limited epitympanic cholesteatoma and retraction pocket received atticotomy. The surgical procedure consisted of eliminating cholesteatoma and pocket, reconstructing lateral epitympanic wall and tympanoplasty with cartilage/perichondrium island flap. RESULT: The anatomic pattern of external ear canal appeared near normal, and the hearing level improved or remained normal during 2-year follow up except for 2 cases with tympanosclerosis. No epitympanic retraction pocket or cholesteatoma relapsed. 1 case appeared tympanic perforation. CONCLUSION: Atticotomy, contemporaneous reconstruction of lateral epitympanic wall and tympanoplasty with cartilage/perichondrium, indicated to be a reliable treatment and prevention technique for epitympanic cholesteatoma. It can achieve good morphological and functional results.

[The clinical analysis of cat scratch diseases with enlarged masses].

OBJECTIVE: In order to raise awareness of CSD and reduce misdiagnosis, we study the manisfection and treatment of CSD with enlarged masses. METHOD: A retrospective study was carried out among the 10 identified patients with CSD on the basis of compatible clinical presentation and confirmatory pathology results for CSD. RESULT: All the 10 patient's first symptoms were masses at some part of the body, more common in the neck. The ratio was 5% at neck, 3% at armpit, 1% at upper, 1% at groin. Two patients had low heat, increased leukocyte and larger masses of more than 2 cm in diameter After surgical resection, and anti-inflammatory treatment. All the patients were cured after surgery and postoperative anti-inflammatory treatment, and there was no recurrence during the 7-year follow-up. CONCLUSION: If patients were diagnosed and treated timely, the prognosis will be good. For the cases with extremely enlarged lymphonodus, surgical operation followed by antimicrobial chemotherapy will be a effective treatment.

[Clinical study of congenital middle ear malformations].

OBJECTIVE: To search into the diagnosis and treatment of congenital malformation of middle ear. METHOD: Nine patients were involved in our study, exploratory tympanotomy was undergone in all patients (eleven ears) and eight ears were reconstructed the ossicular chain. RESULT: Exploratory tympanotomy showed a variety of abnomalities of the middle ear which were difficult to identify preoperatively, despite the modern imaging techniques. Stapedectomy using a wire prosthesis with an oval window tissue graft to prevent a perilymphatic leak was carried out in four ears, fenestration of vestibule with stapes prosthesis in two ears, removing the fibrotic strand around the incudostapedial joint in one ear, TORP (Total replacement prosthesis) were used in one ear, gain in hearing thresholds was obtained without severe complications occurrence. CONCLUSION: Exploratory tympanotomy is essential to identify congenital conductive hearing loss and wire prosthesis may provide a potential way for reconstruction of ossicular chain.